Regular Diameter Implants Research Articles

Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis.

To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.

Narrow-diameter versus regular-diameter dental implants for mandibular overdentures: A systematic review and meta-analysis.

The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs). This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile. A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures. Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.

Influence of diameter in the stress distribution of extra-short dental implants under axial and oblique load

Aim: This study evaluated the influence of a wide diameter on extra-short dental implant stress distribution as a retainer for single implant-supported crowns in the atrophic mandible posterior region under axial and oblique load. Methods: Four 3D digital casts of an atrophic mandible, with a single implant-retained crown with a 3:1 crown-to-implant ratio, were created for finite element analysis. The implant diameter used was either 4 mm (regular) or 6 mm (wide), both with 5 mm length. A 200 N axial or 30º oblique load was applied to the mandibular right first molar occlusal surface. The equivalent von Mises stress was recorded for the abutment and implant, minimum principal stress, and maximum shear stress for cortical and cancellous bone. Results: Oblique load increased the stress in all components when compared to axial load. Wide diameter implants showed a decrease of von Mises stress around 40% in both load directions at the implant, and an increase of at least 3.6% at the abutment. Wide diameter implants exhibited better results for cancellous bone in both angulations. However, in the cortical bone, the minimum principal stress was at least 66% greater for wide than regular diameter implants, and the maximum shear stress was more than 100% greater. Conclusion: Extra-short dental implants with wide diameter result in better biomechanical behavior for the implant, but the implications of a potential risk of overloading the cortical bone and bone loss over time, mainly under oblique load, should be investigated.

Influence of implant diameter on implant survival rate and clinical outcomes in the posterior area: a systematic review and meta-analysis

ObjectiveThe aim of the present systematic review was to test the hypothesis that the diameter of implants inserted in the posterior area affects implant survival rate, prosthetic survival rate and peri-implant parameters (bleeding on probing (BoP), marginal bone loss (MBL), pocket probing depth (PPD)).Materials and methodsAn electronic search of studies published until December 2021 was done on three databases (Pubmed, Scopus, Cochrane) independently by two authors. Clinical trials comparing implant survival rate, BoP, MBL and PPD among narrow diameter implants (NDI: ≥ 3.0 mm to < 3.75 mm) and regular diameter implants (RDI ≥ 3.75 mm to < 5 mm) were included. Data were independently extracted by two reviewers. Risk of bias was evaluated according to the Cochrane risk-of-bias tool for randomized studies and to the Joanna Briggs Institute Critical Appraisal tools for non-randomized ones. A pair-wise meta-analysis was conducted on the included studies.ResultsSeven articles were included out of the 4291 identified from the digital research. Overall, a total of 939 implants were inserted (319 NDI, 620 RDI). Only one study was judged at serious risk of bias. No statistically significant difference was found in implant survival rate (risk ratio 1.01 (95% CI [0.98 to 1.04], P = 0.67)) while the difference was significant for BoP (mean difference 2.89 (95% CI [0.30 to 5.48] mm, P = 0.03)) with higher values for NDI. Higher MBL was identified among regular diameter implants (mean difference -0.15 mm (95% CI [-0.32 to 0.01 mm], P = 0.07). No statistically significant differences were identified for prosthetic survival and PPD.ConclusionsNo differences were found in implant survival rate between narrow and regular implants. A higher BoP was identified among narrow implants, but there was no higher bone loss. It is not possible to draw definitive conclusions about the use of narrow-diameter implants in the posterior region.

Screw-retained internal connection zirconia CAD-CAM abutments in single implant reconstructions: Results of a 1-year prospective case series study.

To evaluate the clinical and radiographic outcomes of single-tooth implant restorations using one-piece, internally connected, screw-retained, computer-aided design and computer-aided manufactured monolithic zirconia restorations fabricated on regular diameter implants. Following a 2-stage surgical procedure, 22 implants placed in anterior and posterior areas in 21 partially edentulous patients (mean age of 55 years; 9 males/12 females) were evaluated in terms of plaque index, pocket probing depth, bleeding on probing, level of oral hygiene (OH), signs of mucositis/peri-implantitis, esthetic score (ES), gingival zenith position (GZP), papilla index score, the thickness of peri-implant gingiva, radiographic marginal bone loss, and technical complications. Implants and restorations were prospectively followed from the insertion of the restoration (baseline), up to 12-months post-loading. A 100% implant survival rate resulted after loading; one implant was lost before loading. Clinically, patients performed an adequate OH, and tissues were kept healthy. Probing depth showed a slightly lower value at baseline compared to any follow-up examination (2.26 [0.94] at baseline vs. 2.53 [0.66]mm at 12 months). ES, GZP, and the thickness of the peri-implant gingiva improved throughout the course of the study. Radiographically, average marginal bone level (MBL) was 0.40 (0.40)mm after 1-year follow-up with no differences in average MBL at all time points. Technically, after 1 year of clinical function, neither abutment fracture nor any other serious complications occurred. Hence, prosthetic reconstruction survival rate was 100%. Clinical outcomes of single-tooth implant restorations using internally connected, screw-retained, computer-aided design and computer-aided manufacturing monolithic zirconia abutments can be considered a reliable treatment alternative after 1-year clinical observation.

Rotational Load Fatigue Performance of Titanium vs Titanium-Zirconium Implant-Abutment Connections.

Titanium-zirconium (Ti-Zr) alloy has been developed to strengthen the implant body, but clinically relevant information is still limited. The aim of this in vitro study was to compare the rotational load fatigue performance of implant-abutment connections in narrow-diameter (3.3-mm) and regular-diameter (4.1-mm) implants made with commercially pure grade 4 titanium alloy (CPTi-G4) and Ti-Zr. Narrow-diameter (N) and regular-diameter (R) implants with CPTi-G4 (Ti) or Ti-Zr (Tz) materials were tested. This resulted in four test groups: NTi, NTz, RTi and RTz. Five specimens were made for each group (n = 5). Abutments used were milled from titanium-aluminum-niobium alloy abutment blanks. A rotational load fatigue machine applied a sinusoidally varying load at an angle of 45 degrees to produce an effective bending moment of 35 Ncm at a frequency of 14 Hz in air at 20°C. The number of cycles to failure was recorded. The upper limit was set as 5 million cycles. Results were evaluated using analysis of variance (ANOVA) and Tukey post hoc tests. Failure locations and patterns were evaluated with scanning electron microscope (SEM). All regular-diameter test groups reached the upper limit of 5 million cycles without failure. All narrow-diameter test groups failed within the range of 402,530 cycles to 3,374,353 cycles. It could be observed that NTz showed a higher mean cycle count as compared to NTi. NTi test group recorded two implants damaged, one implant fracture, five abutment fractures, and four screw fractures. NTz test group showed only abutment fractures at the level of implant platform, with no damage to the implant bodies. Significant difference was found between implants of different diameters. There was no significant difference between implants of different materials. Regular-diameter implants performed significantly better than narrow-diameter implants, regardless of material, while no significant difference in cyclic load to failure was found between groups of different alloys. All NTz failures were at the abutment only, without damage to the implant. This failure pattern can potentially be clinically advantageous in terms of retrieval and subsequent replacement of a failed prosthesis.

Restoration of a wide edentulous posterior site with two small-diameter implants: Biologically-driven alternative treatment

Crestal bone stability, implant rigidity and occlusal loading are issues with small-diameter implants. This article demonstrates the use of two small-diameter implants replacing a missing wide edentulous site and discusses factors that may affect bone changes. Patients who wanted to restore an edentulous space measuring from 12 to 14mm wide in the posterior region were offered an alternative treatment option, using two narrow or regular-diameter implants instead of one wide implant. In the study, the crestal bone stability of 12 implants in 6 edentulous sites was assessed by cone beam CTs and periapical radiographs in follow-up visits for up to 4 years. The bone level of all the implants was stable at buccal, lingual, mesial and distal sites, with mean values<1mm. The average buccal bone thickness was 1.15±1.07mm and lingual was 1.86±0.89mm, meaning that implants were surrounded by a sufficient amount of bone. The good treatment outcome may be attributed to the capability of fabricating better emergence profiles, angles (Mean: 20.67±7.82°at the mesial and 20.25±8.23°at the distal site) and cleansable embrasures of prostheses which are key to maintaining good oral hygiene and implant health. Using two narrow or regular-diameter implants to replace a single edentulous site measured around 12-14mm wide in posterior region seemed to be a feasible treatment option. It is especially suitable for sites with ridge atrophy and/or patients suffering from systemic diseases.

Histomorphometric Analysis of Osseointegrated Grade V Titanium Mini Transitional Implants in Edentulous Mandible by Backscattered Scanning Electron Microscopy (BS-SEM)

The purpose of this study is to assess the use of grade V titanium mini transitional implants (MTIs) immediately loaded by a temporary overdenture. For this, a histomorphometric analysis of the bone area fraction occupancy (BAFO) was performed by backscattered scanning electron microscopy (BS-SEM). Four female patients were submitted to surgery in which two MTIs were installed and immediately loaded with a temporary acrylic prosthesis. During the same surgery, two regular diameter implants were placed inside the bone and maintained without mechanical load. After 8 months, the MTIs were extracted using a trephine and processed for ultrastructural bone analysis by BS-SEM, and the regular-diameter implants were loaded with an overdenture device. A total of 243 BAFOs of MTIs were analyzed, of which 94 were mainly filled with cortical bone, while 149 were mainly filled with trabecular bone. Bone tissue analysis considering the total BAFOs with calcified tissues showed 72.13% lamellar bone, 26.04% woven bone, and 1.82% chondroid bone without significant differences between the samples. This study revealed that grade V titanium used in immediately loaded MTI was successfully osseointegrated by a mature and vascularized bone tissue as assessed from the BAFO.

A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study

BackgroundImmediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.MethodsForty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.ResultsThe overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.ConclusionsThe results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.

Narrow-diameter implants versus regular-diameter implants for rehabilitation of the anterior region: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate studies comparing implant survival rates, marginal bone loss (MBL), and mechanical and biological complication rates between narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) used for oral rehabilitation in the anterior region. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases for studies published until May 2020. A total of 843 implants (484 NDIs and 359 RDIs) were included. No significant difference in implant survival rate (risk difference (RD) 0.01, 95% confidence interval (CI) −0.01 to 0.03; P=0.34), MBL (standardised mean difference −0.51mm, 95% CI −1.29 to 0.26mm; P=0.19), mechanical complications (RD 0.01, 95% CI −0.02 to 0.04; P=0.40), or biological complications (RD 0.01, 95% CI −0.09 to 0.11; P=0.85) was found between the implant groups. Within the limitations of this study, it is concluded that NDIs are an effective alternative to RDIs due to similar survival rates, MBL, and mechanical and biological complication rates. However, future studies are highly encouraged due to the small number of interventional studies on this topic.

Does implantoplasty affect the failure strength of narrow and regular diameter implants? A laboratory study

ObjectiveTo assess whether the impact of implantoplasty (IP) on the maximum implant failure strength depends on implant type/design, diameter, or material.MethodsFourteen implants each of different type/design [bone (BL) and tissue level (TL)], diameter [narrow (3.3 mm) and regular (4.1 mm)], and material [titanium grade IV (Ti) and titanium-zirconium alloy (TiZr)] of one company were used. Half of the implants were subjected to IP in a computerized torn. All implants were subjected to dynamic loading prior to loading until failure to simulate regular mastication. Multiple linear regression analyses were performed with maximum implant failure strength as dependent variable and IP, implant type/design, diameter, and material as predictors.ResultsImplants subjected to IP and TL implants showed statistically significant reduced implant failure strength irrespective of the diameter compared with implants without IP and BL implants, respectively. Implant material had a significant impact for TL implants and for regular diameter implants, with TiZr being stronger than Ti. During dynamic loading, 1 narrow Ti TL implant without IP, 4 narrow Ti TL implants subjected to IP, and 1 narrow TiZr TL implant subjected to IP were fractured.ConclusionIP significantly reduced the maximum implant failure strength, irrespective implant type/design, diameter, or material, but the maximum implant failure strength of regular diameter implants and of narrow BL implants remained high.Clinical RelevanceIP seems to have no clinically relevant impact on the majority of cases, except from those of single narrow Ti TL implants, which may have an increased risk for mechanical complications. This should be considered for peri-implantitis treatment planning (e.g., communication of potential complications to the patient), but also in the planning of implant installation (e.g., choosing TiZr instead of Ti for narrow implants).

Finite element analysis of narrow dental implants

Narrow-diameter implants (NDIs) traditionally have been associated to higher rates of failure in comparison with regular-diameter implants (RDIs) and wide-diameter implants (WDIs), since they generate a more unfavorable stress distribution in peri-implant bone. However, it is well known that the load sharing effect associated with prostheses supported by multiple implants (also called splinted prostheses) affords mechanical benefits. The present study involves finite element analysis (FEA) to determine whether the risks linked to NDIs could be mitigated by the mechanical advantages afforded by the splinting concept. For this purpose, a three-dimensional (3D) model of a real maxilla was reconstructed from computed tomography (CT) images, and different implants (NDIs, RDIs and WDIs) and prostheses were created using computer-aided design (CAD) tools. Biting forces were simulated on the prostheses corresponding to three different rehabilitation solutions: single-implant restoration, three-unit bridge and all-on-four treatment. Stress distribution around the implants was calculated, and overloading in bone was quantified within peri-implant volumes enclosed by cylinders with a diameter 0.1mm greater than that of each implant. The mechanical benefits of the splinting concept were confirmed: the peri-implant overloaded volume around NDIs splinted by means of the three-unit bridge was significantly reduced in comparison with the nonsplinted condition and, most importantly, proved even smaller than that around nonsplinted implants with a larger diameter (RDIs). However, splinted NDIs supporting the all-on-four prosthesis led to the highest risk of overloading found in the study, due to the increase in compressive stress generated around the tilted implant when loading the cantilevered molar.

Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study

BackgroundThere is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period.Materials and methodsFifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bone to expect primary implant stability and an implant site free of infection, were included. The implants, with a large thread depth and sharp thread edges, were placed in each patient according to a two-staged surgical procedure. Three months later, a full contour screw-retained zirconia restoration with an angulated screw channel abutment was provided. Clinical and radiographic examinations were performed 1 month and 12 months after placing the restoration. In addition, the patients’ satisfaction with the restoration was scored after 12 months.ResultsFour out of 15 of the mobile implants had to be removed before the 1-year evaluation. The implant and restoration survival rates were 73.3% at the 1-year evaluation (n = 15). The mean marginal bone loss, from loading to the 12-month follow-up, was 0.17 mm (n = 11). The mean plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth scores were low, depicting healthy peri-implant conditions. The patients were very satisfied.ConclusionIt was demonstrated, within the limitations of this study, that immediate placement of regular diameter implants in molar post-extraction sites in the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.Trial registrationNetherlands Trial Register, NL8117. Registered 24 October 2019 - Retrospectively registered, https://www.trialregister.nl/trial/8117.

Clinical and radiographic assessment of narrow-diameter and regular-diameter implants in the anterior and posterior jaw: 2 to 6 years of follow-up.

PurposeThe present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw.MethodsPatients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications.ResultsSeventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale.ConclusionsNDIs in the anterior and posterior jaws functioned equally well in terms of peri-implant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

Survival rate and clinical evaluation of the implants in implant assisted removable partial dentures: surveyed crown and overdenture.

PURPOSEThe purpose of this study was to investigate survival rates of the implants used in implant assisted removable partial dentures (IARPDs).MATERIALS AND METHODSThe study was conducted on 21 patients who were treated with IARPDs. The mean follow-up period for IARPD patients ranged from 12 to 185 months (mean 47.9 months). A total of 58 implants were used for IARPDs in two different modalities: 41 for surveyed crowns and 17 for overdentures. The survival of implants was determined by clinical and radiographic evaluations considering relevant factors: location, RPD classification, opposing dentition, splinting, and implant diameter.RESULTSThe survival rate of total 58 implants was 93.1%: 95.1% for implants supporting surveyed crowns and 88.2% for implants used in overdentures. Considering only the implants supporting surveyed crown, regular diameter implants showed a higher survival rate than narrow or wide diameter implants.CONCLUSIONThe survival rate of the implants used in IARPDs was 93.1% (surveyed crown: 95.1%, overdenture: 88.2%).

The Clinical Performance of Narrow Diameter Implants Versus Regular Diameter Implants: A Meta-Analysis.

The purpose of this study is to analyze 1- and 3-year clinical performances of narrow diameter implants (NDIs) versus regular diameter implants (RDIs). A search of electronic databases and a manual search was performed for the time period January 2000 to April 2018. A meta-regression was used to evaluate the effects of the "fixed effects" model on the implant survival rates, prosthesis success rates and marginal bone loss (MBL) with follow-up time of 1 year and 3 years. Of the 11 studies included, the overall combined 1-year implant survival rates were 98.14% for NDIs and 98.20% for RDIs. The overall combined 3-year implant survival rates were 98.71% for NDIs and 98.84% for RDIs. The corresponding values for 1-year prosthesis success rates were 96.94% for NDIs and 99.25% for RDIs. The corresponding values for 3-year prosthesis success rates were 89.25% for NDIs and 96.55% for RDIs. The meta-regression showed no significant differences between NDIs and RDIs regarding implant survival rates, prosthesis success rates, and MBL in 1-year and 3-year follow-up (P > .05). The results of this meta-analysis concluded that the implant diameter did not affect its survival rates, prosthesis success rates, and MBL in 1 and 3 years. The use of NDIs instead of bone augmentation procedures with RDIs did not affect its survival rates, prosthesis success rates, and MBL in the short-term and middle-term. However, more high-quality randomized controlled trials and long follow-up studies are needed on this topic.

An Easy Approach for the Fabrication of Surgical Template for Placement of Mini-implant

The success of dental implant depends on meticulous treatment planning. Restorative problems are often common with improper placement of implants, especially where the alveolar bone quantity is compromised. The accuracy needed in placement of the mini-implant is even more. Hence, the use of a surgical guide becomes essential. Various authors have suggested techniques for the fabrication of surgical and radiographic stents. These techniques make use of different materials in fabrication of stent. This article presents a simple technique for the fabrication of a surgical guide for the placement of mini-implants using simple readily available materials. The technique can be modified to be used for regular diameter implants.

Narrow-diameter implants in the anterior region: A meta-analysis.

Implants in the anterior region are challenging, and literature reporting outcomes of narrow-diameter implants (NDIs) in anterior sites is scarce. This systematic review summarized evidence of functional and esthetic performance of anterior single crowns supported by NDIs. Ten databases were searched to find studies evaluating anterior single crowns supported by NDIs. Risk of bias was assessed, and random-effects meta-analyses were applied to analyze mean differences in survival, success, and marginal bone level (MBL). The review was registered in the PROSPERO database (CRD42018089886). Twenty-one studies meeting the screening criteria were included for qualitative analysis, and three for meta-analysis. A total of 892 NDIs, placed in 736 patients, were analyzed. Follow-up duration varied from 12 months to 14 years (mean: 40 months), and 16 failures (implant loss) were recorded. Fixed-effect meta-analysis (I2 = 0%) of survival rate revealed a risk difference of 0.02 (95% CI: -0.03 to 0.08), between NDIs and controls (regular-diameter implants), without differences between groups (P = .39). Success rates ranged from 84.2% to 100% (mean: 95.2%). Random-effects meta-analysis (I2 = 56%) of MBL indicated a mean difference of 0.02 mm (95% CI: -0.21 to 0.25), without differences between groups (P = .87). Single crowns supported by NDIs are a predictable treatment, since their survival rate and MBL are comparable to those supported by regular-diameter implants. Due to data shortage reporting esthetic outcomes, more studies are needed to evaluate the long-term performance of the single crowns supported by NDIs in the anterior region.

Longitudinal assessment of clinical and radiographic periimplant status around narrow and regular diameter implants placed in cigarette-smokers and nonsmokers.

To date, no clinical investigation has assessed the clinical and radiographic indices around narrow diameter implants (NDIs) and regular diameter implants (RDIs) in individuals with cigarette smoking habit and nonsmokers. To estimate and compare the clinical and radiographic indices around NDIs (< 3.3 mm) and RDIs placed in cigarette smokers (CS) and nonsmokers (NS). Eighty-six patients requiring implant surgery in the anterior mandible were divided into two groups (39 CS and 43 NS). Patients were further categorized into two subgroups on the basis of implant diameter: (a) patients with NDIs (3.3 mm) and (b) patients with RDIs (4.1 mm). Clinical indices evaluating plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded at 18 and 36 months of follow-up. Digital periapical radiographs were studied to evaluate crestal bone levels (CBL) incorporating in a specialized software and examined on a calibrated computer display screen with the help of an image analyzer. The mean age of patients in CS group and NS group was 44.6 and 42.5 years, respectively. There was no statistically significant difference in the overall mean scores of PI, PD, and CBL around NDIs and RDIs among CS and NS patients at 18 and 36 months of follow-up. However, there was a statistically significant difference only in the overall mean BOP around NDIs and RDIs among CS and NS patients at 18 and 36 months of follow-up. The findings of the current study suggests that NDIs can show reliable clinical stability and radiographic bone levels as RDIs placed in CS and NS, with the support of strict oral hygiene protocols.

Comparison of clinical peri-implant indices and crestal bone levels around narrow and regular diameter implants placed in diabetic and non-diabetic patients: A 3-year follow-up study.

Studies evaluating and comparing clinical and radiographic peri-implant indices around narrow diameter implants (NDIs; <3.3 mm) and regular diameter implants (RDIs) in type-2 diabetes mellitus (T2DM) and non-diabetic individuals are deficient. To estimate and compare the clinical and radiographic indices around NDIs and RDIs placed in T2DM and non-diabetic patients. Eighty-six patients requiring implant surgery in the posterior mandible were divided into two groups (42 T2DM and 44 non-diabetic individuals). Patients were further categorized into two subgroups on the basis of diameter of implants: (1) patients with NDIs (3.3 mm ø) and (2) patients with RDIs (4.1 mm ø). Clinical indices evaluating plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone levels (CBL) were recorded around all dental implants at 18 and 36 months follow up. Serum hemoglobin A1c (HbA1c) test was carried out for both groups to assess the profile of glycosylated hemoglobin at baseline, 18 and 36 months of follow up. The mean age of patients in T2DM group and non-diabetic group was 45.2 and 41.6 years, respectively. At 18 and 36 months follow up, mean HbA1c levels were 6.5% and 4.5% and 6.7% and 4.5% in T2DM and non-diabetic individuals, respectively. A statistically significant reduction in mean HbA1c levels from the baseline to respective follow-up periods were seen in T2DM patients. There was no statistically significant difference in the overall mean scores of PI, BOP, PD, and CBL around NDIs and RDIs among T2DM and non-diabetic patients at 18 and 36 months of follow up. NDIs show reliable clinical stability and radiographic bone levels as RDIs placed in T2DM and non-diabetic individuals, provided oral hygiene and glycemic status are strictly maintained.